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Investigation of microbial keratitis: an audit from 1988-1992
P R Simcock1, J M Butcher, M Armstrong
1Manchester Royal Eye Hospital, England.
Abstract:
An audit was performed of the investigation of 263 cases of microbial keratitis severe enough to be admitted to the Manchester Royal Eye Hospital over the 5-year period, 1988-1992. A pathogen isolation rate of 37% was noted during the first year which increased to 79% (p < 0.05) by the final year of audit. In late 1991 a new method of inoculating enrichment broths was introduced, which also contributed by increasing the yield from corneal scrapes. The audit process resulted in the development of and adherence to our investigation protocol, improved communication between Manchester Royal Eye Hospital and the microbiology laboratory, the implementation of a new investigatory method, and a significantly improved microbial isolation rate.
Insights
An audit of microbial keratitis investigations improved pathogen isolation rates from 37% to 79% through protocol adherence and new methods. This enhanced diagnostic yield in severe eye infections.
Area of Science:
- Ophthalmology
- Medical Microbiology
Background:
- Microbial keratitis is a severe eye infection requiring prompt and accurate diagnosis.
- Effective investigation protocols are crucial for identifying causative pathogens and guiding treatment.
Purpose of the Study:
- To audit the investigation process for microbial keratitis cases admitted to Manchester Royal Eye Hospital.
- To assess the impact of an audit on diagnostic yield and laboratory communication.
Main Methods:
- Retrospective audit of 263 microbial keratitis cases (1988-1992).
- Analysis of pathogen isolation rates before and after protocol implementation.
- Introduction of a new enrichment broth inoculation method for corneal scrapes.
Main Results:
- Pathogen isolation rate increased significantly from 37% to 79% (p < 0.05) over the audit period.
- The new inoculation method improved yield from corneal scrapes.
- Enhanced communication between the hospital and microbiology laboratory was achieved.
Conclusions:
- Auditing investigation protocols can significantly improve microbial isolation rates in microbial keratitis.
- Implementation of standardized protocols and improved laboratory methods enhance diagnostic accuracy.
- Effective collaboration between clinical and laboratory teams is vital for managing severe eye infections.